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An exploration of the feasibility and clinical value of half-dose 5-h total-body 18F-FDG PET/CT scan in patients with Takayasu arteritis

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To explore the feasibility and clinical value of 5-h delayed 18F-fluorodeoxyglucose (18F-FDG) total-body (TB) positron emission tomography/computed tomography (PET/CT) in patients with Takayasu arteritis (TA).

Methods

This study included nine healthy volunteers who underwent 1-, 2.5-, and 5-h triple-time TB PET/CT scans and 55 patients with TA who underwent 2- and 5-h dual-time TB PET/CT scans with 1.85 MBq/kg 18F-FDG. The liver, blood pool, and gluteus maximus muscle signal-to-noise ratios (SNRs) were calculated by dividing the SUVmean by its standard deviation to evaluate imaging quality. TA lesions’ 18F-FDG uptake was graded on a three-point scale (I, II, III), with grades II and III considered positive lesions. Lesion-to-blood maximum standardised uptake value (SUVmax) ratio (LBR) was calculated by dividing the lesion SUVmax by the blood pool SUVmax.

Results

The liver, blood pool, and muscle SNR of the healthy volunteers at 2.5- and 5-h were similar (0.117 and 0.115, respectively, p = 0.095). We detected 415 TA lesions in 39 patients with active TA. The average 2- and 5-h scan LBRs were 3.67 and 7.59, respectively (p < 0.001). Similar TA lesion detection rates were noted in the 2-h (92.0%; 382/415) and 5-h (94.2%; 391/415) scans (p = 0.140). We detected 143 TA lesions in 19 patients with inactive TA. The 2- and 5-h scan LBRs were 2.99 and 5.71, respectively (p < 0.001). Similar positive detection rates in inactive TA were noted in the 2-h (97.9%; 140/143) and 5-h (98.6%; 141/143) scans (p = 0.500).

Conclusion

The 2- and 5-h 18F-FDG TB PET/CT scans had similar positive detection rates, but both combined could better detect inflammatory lesions in patients with TA.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

18F-FDG:

18F-fluorodeoxyglucose

AFOV:

Axial field-of-view

ESR:

Erythrocyte sedimentation rate

LLR:

Lesion-to-liver maximum standardized uptake value ratio

LBR:

Lesion-to-blood maximum standardized uptake value ratio

MR:

Magnetic resonance

PET/CT:

Positron emission tomography/computed tomography

ROI:

Region of interest

SNR:

Signal-to-noise ratio

SUVblood :

Blood maximum standard uptake value

SUVliver :

Liver maximum standard uptake value

SUVmax :

Maximum standard uptake value

SUVmean :

Mean standard uptake value

TA:

Takayasu arteritis

TB:

Total-body

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Funding

This work was supported by grants from the Three-year Action Plan of Clinical Skills and Innovation of Shanghai Hospital Development Center (No. SHDC2020CR3079B to H. S.), the Shanghai Municipal Key Clinical Specialty (No. shslczdzk03401 to H. S.), the Science and Technology Committee of Shanghai Municipality (No. 20DZ2201800 to Y.Z.), the Clinical Research Project of Zhongshan Hospital, Fudan University (No. 2020ZSLC63 to Y.Z.), and the Shanghai "Rising Stars of Medical Talent" Youth Development Program (No. SHWRS[2020]_087 to Y.Z.).

Author information

Author notes

  1. Dilibire Adili and Danjie Cai equally contributed to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Dilibire Adili, Danjie Cai, Bing Wu, Haojun Yu, Yushen Gu, Yiqiu Zhang & Hongcheng Shi

  2. Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China

    Dilibire Adili, Danjie Cai, Bing Wu, Haojun Yu, Yushen Gu, Yiqiu Zhang & Hongcheng Shi

  3. Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Dilibire Adili, Danjie Cai, Bing Wu, Haojun Yu, Yushen Gu, Yiqiu Zhang & Hongcheng Shi

  4. Cancer Prevention and Treatment Center, Zhongshan Hospital, Fudan University, Shanghai, 200032, China

    Dilibire Adili, Danjie Cai, Bing Wu, Haojun Yu, Yushen Gu, Yiqiu Zhang & Hongcheng Shi

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Contributions

Dilibire Adili, Danjie Cai, Bing Wu, Yushen Gu, Yiqiu Zhang, and Hongcheng Shi were involved designing the study. Dilibire Adili, Danjie Cai, Yiqiu Zhang, and Hongcheng Shi contributed to data analysis and manuscript preparation. Haojun Yu helped with image acquisition and processing. All authors discussed the results and commented on the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Yiqiu Zhang or Hongcheng Shi.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the 1964 Declaration of Helsinki and its later amendments. The Ethics Committee of Zhongshan Hospital, Fudan University approved this retrospective study. Written informed consent was obtained from all participants.

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Informed consent was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1, 3, 4, and 5.

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The authors declare that they have no competing interests.

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Adili, D., Cai, D., Wu, B. et al. An exploration of the feasibility and clinical value of half-dose 5-h total-body 18F-FDG PET/CT scan in patients with Takayasu arteritis. Eur J Nucl Med Mol Imaging 50, 2375–2385 (2023). https://doi.org/10.1007/s00259-023-06168-6

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